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Mesothelioma

Expert Fact Checked

This page was medically reviewed by James Stevenson, M.D.. For information on our content creation and review process read our editorial guidelines. If you notice an error or have comments or questions on our content please contact us.

James Stevenson, M.D. Thoracic Medical Oncologist


Mesothelioma cancer is caused by asbestos exposure. It most commonly forms in the lining around the lungs or abdomen. Average life expectancy is 18 – 31 months. Symptoms can include chest pain and shortness of breath. Treatments like surgery, chemotherapy and immunotherapy can help improve survival.

Key Facts
Pleural

Most common type of mesothelioma that makes up more than 80% of diagnoses

72 years

Average age at diagnosis for pleural mesothelioma

3,000

Approximate new mesothelioma cases diagnosed each year

10 – 50 years

Usual time between asbestos exposure and mesothelioma symptoms

01. Mesothelioma Overview

What Is Mesothelioma Cancer?

Mesothelioma, a rare and aggressive form of cancer, develops in the linings of certain tissues. Pleural mesothelioma and peritoneal mesothelioma are the two most common types. Pleural mesothelioma develops in the lining around the lungs, and peritoneal mesothelioma develops in the lining that surrounds the organs in the abdomen. Other types are pericardial mesothelioma and testicular mesothelioma.

What Type of Cancer Is Mesothelioma?

Mesothelioma is a rare cancer that develops in the mesothelium (thin lining surrounding certain tissues and organs). It often forms in the:

  • Lung lining (pleural mesothelioma)
  • Belly lining (peritoneal mesothelioma)
  • Heart lining (pericardial mesothelioma)
  • Testicle lining (testicular mesothelioma)

Mesothelioma tumors can be made of different cell types. Doctors may recommend different treatments based on a patient’s cell type.

Malignant mesothelioma cancer develops because of asbestos exposure. Asbestos is a fibrous mineral that can look like dust or powder. If inhaled or ingested, the fibers can lodge in internal organs and later cause tumors to develop. People who experience on-the-job asbestos exposure generally have a higher risk of developing mesothelioma.

For mesothelioma patients, average life expectancies range from 18 to 31 months with treatment. Treatment often helps improve factors like quality of life and survival. Treatment plans may include traditional methods like surgery and chemotherapy or newer ones like immunotherapy. Multimodal plans, which combine different treatments, are common.

02. Symptoms

Mesothelioma Symptoms

Mesothelioma disease symptoms include chest and abdominal pain, fluid buildup and coughing. They can take 10 – 50 years (the latency period) to present after initial asbestos exposure. When symptoms do appear, they can easily be mistaken for less serious illnesses. The flu, pneumonia or intestinal troubles may have similar symptoms.

Latency period and delay in symptom reporting may complicate the mesothelioma diagnostic process. If you or a loved one have a history of asbestos exposure, it can be helpful to provide this information to a doctor, who can then do periodic checkups. This may help lead to an earlier diagnosis and treatment plan.

With an earlier diagnosis, patients may have different treatment options. In some cases, early detection can come with an improved mesothelioma prognosis.

Common Symptoms of Malignant Mesothelioma

The amount, severity and type of mesothelioma symptoms vary for each patient. Common signs and symptoms of mesothelioma include:

  •  Abdominal or chest pain
  • Coughing or wheezing
  • Difficulty breathing (dyspnea)
  • Fatigue
  • Fever and night sweats
  • Fluid buildup
  • Loss of appetite
  • Muscle weakness
  • Shortness of breath
  • Unexplained weight loss

Asbestos is the only definitive cause of malignant mesothelioma. When asbestos fibers are inhaled or ingested, they may embed in the lining of the lungs (pleura), abdomen (peritoneum) or heart (pericardium). Over time, the fibers can cause inflammation and scarring. This irritation can later lead to the development of mesothelioma cancer tumors.

Depiction of the route asbestos fibers take from inhalation to the areas of the body in which they cause cancers. The background is a silhouette of a person. Small asbestos fibers are shown traveling into the mouth, through the esophagus and trachea, and finally settling in the linings around the lung, heart and abdomen. These locations correspond to pleural, pericardial and peritoneal mesothelioma respectively

How Mesothelioma Develops

  • Exposure: A person is exposed to asbestos fibers, which are easily inhaled or ingested.
  • Embedding: The asbestos fibers become lodged in the linings of internal organs, like the lungs, abdomen and heart.
  • Inflammation: Embedded fibers irritate and damage surrounding tissue.
  • Cancer: Over time, tumors begin to form in the damaged tissue.

Who Is at Risk of Developing Mesothelioma?

People who often come into contact with asbestos are the most at risk of developing mesothelioma. Workers in asbestos industries generally experience higher rates of exposure. But any amount of asbestos exposure can cause this cancer.

High-risk occupations for exposure include:

Veterans are also at a high risk of asbestos exposure. During the 20th century, the military used asbestos throughout the branches in existence at the time. As a result, veterans of the Air Force, Army, Coast Guard, Marine Corps and Navy may have encountered asbestos during their time in active service.

Families of workers and veterans may face secondary exposure risks. This happens when someone brings asbestos home on their clothing, hair or skin. People who experienced secondhand exposure have gone on to develop mesothelioma cancer.

04. Types

Types of Mesothelioma

There are four main types of mesothelioma, each based on the location of tumors. Prognosis, symptoms and treatment options vary between the types.

Pleural Mesothelioma

Pleural mesothelioma illustration showing a set of lungs, split down the middle to show the difference between a healthy patient and one with mesothelioma. There is a healthy lung with no tumors on the left side. On the right is a lung with mesothelioma tumors on its outer lining.

  • Pleural mesothelioma develops in the lining around the lungs.
  • It is the most common type of the disease, accounting for more than 80% of all diagnoses.
More About Pleural Mesothelioma

Peritoneal Mesothelioma

An illustration showing organs in the abdomen and the peritoneum with tumors growing in it. It represents how peritoneal mesothelioma affects a patient.

  • Peritoneal mesothelioma develops in the lining surrounding the abdomen.
  • It is the second most common form of the disease, accounting for about 10% – 15% of all diagnoses.
More About Peritoneal Mesothelioma

Pericardial Mesothelioma

An image shows a heart and the protective tissue, the pericardium surrounding it. A tumor grows on the pericardium, suggesting pericardial mesothelioma.

  • Pericardial mesothelioma develops in the lining surrounding the heart.
  • It is an extremely rare form of the disease, accounting for less than 1% of all diagnoses.
More About Pericardial Mesothelioma

Testicular Mesothelioma

An image representing testicular mesothelioma. It shows the inside of the testicle and details the thin protective layer called the tunica vaginalis. It highlights a hydrocele, or swelling in the tissue around the testicle. A small tumor shows on the tunica vaginalis.

  • Testicular mesothelioma develops in the lining around the testicles.
  • It is one of the rarest forms of the disease, accounting for less than 1% of all diagnoses.
More About Testicular MesotheliomaMore About Testicular Mesothelioma

Mesothelioma tumors can be made of different types of cells with varied properties. The three main mesothelioma cell types are:

  • Epithelioid mesothelioma: The tumors contain cells that look similar to epithelial cells found in the skin and other common tissues. This is the most common mesothelioma cell type. Compared to other cell types, epithelioid mesothelioma responds well to treatment.
  • Sarcomatoid mesothelioma: The tumors contain cells that look like sarcoma cells, which are a type of cancer cell. This cell type generally responds to immunotherapy better than chemotherapy.
  • Biphasic mesothelioma: The tumors contain a combination of epithelioid and sarcomatoid cells. In general, this type occurs in the pleura (lung lining) or peritoneum (abdominal lining). The percentage of each cell type may affect which treatment options are available.

Recommended treatment methods vary based on mesothelioma cell type and location. Doctors can create customized treatment plans based on each individual case.

It is important to diagnose malignant mesothelioma as early as possible. After recognizing symptoms, doctors confirm a mesothelioma diagnosis with a biopsy. Tissue biopsies are the only way to definitively diagnose mesothelioma.

People who know or suspect asbestos exposure can tell their doctors. A doctor can watch for signs of asbestos cancer. Those who develop symptoms can find specialists experienced in diagnosing mesothelioma.

Common Tests for Diagnosing Mesothelioma

Mesothelioma patients may receive a number of tests to help doctors reach a diagnosis. These tests may have different goals. For example, blood tests may help doctors order additional diagnostic tests. Common diagnostic tests include:

  • Imaging scans: Doctors often use imaging scans like MRIs and CT scans early in the diagnostic process. These tests are still useful after a diagnosis is confirmed. For example, chest X-rays can help doctors determine the extent and location of tumors.
  • Biopsies: A biopsy removes tissue or fluid for testing. It is the only way to diagnose mesothelioma. Other tests can play a role in the diagnosis process, but only biopsy testing can be conclusive.

Doctors may also order tests for other reasons. For example, a biopsy can also help determine important disease factors, like cell type. Doctors may also use testing to better understand cancer location and stage.

06. Stages

Mesothelioma Stages

After confirming a mesothelioma diagnosis, doctors often go on to estimate its stage. The most common method to determine mesothelioma stage is the tumor node metastasis (TNM) system. Stages range from early (stages 1 and 2) to later (stages 3 and 4).

This information helps doctors understand prognosis and treatment options. In stages 1 and 2, patients may have varied treatment options. In stages 3 and 4, the cancer has spread (metastasized). This may mean patients have different treatment options than in earlier stages.

A graphic image depicting the four stages of pleural mesothelioma, from stage 1 when the cancer is localized in the pleura, to stage 4 when the cancer has spread to the abdomen, chest, neck and bones.

Stage 1

With stage 1 mesothelioma, the cancer is only in specific or localized areas of the body. Aggressive treatments, like surgery, are often still an option. Life expectancy ranges from 21 months to more than 5.5 years with treatment.

Stage 2

With stage 2 mesothelioma, the cancer has spread to nearby organs and lymph nodes. Some aggressive treatments, like surgery, may still be an option. Life expectancy ranges from 19 months to about 5.5 years with treatment.

Stage 3

With stage 3 mesothelioma, the cancer spreads further to other organs and tissues. Treatment options may become more limited. Life expectancy ranges from 16 months to nearly 5 years with treatment.

Stage 4

With stage 4 mesothelioma, the cancer spreads further to distant organs and tissues. Patients often have therapeutic and palliative treatment options to choose from. Life expectancy ranges from 12 to 26 months with treatment.

Doctors use several factors to estimate prognosis, but an individual’s experience may differ from this estimate. Patients from stages 1 to 4 have outlived their original life expectancies. Research advances continue expanding treatment options for early- and late-stage cases.

07. Prognosis

Mesothelioma Prognosis

Prognosis is the medical expectation for how a patient’s disease will progress. A mesothelioma prognosis includes life expectancy, quality of life and other aspects of a patient’s experience. Doctors use information like stage and cell type to estimate survival time and the best treatment options for improving prognosis.

When discussing their prognosis, patients will often hear other related terms, including:

  • Life expectancy: An estimate of the amount of time they will live after diagnosis. This is presented in months or years.
  • Survival rate: The percentage of people in a certain group who are still alive at a specific point in time. This is typically reported in 1-, 2-, 3- or 5-year increments.

Each patient’s prognosis will vary based on many individual factors, including age and overall health. In general, treatment can help improve a patient’s prognosis. Mesothelioma specialists can create a personalized treatment plan for each patient. They can also explain what to expect during the mesothelioma treatment process.

Mesothelioma Survivors

A prognosis is a complex estimate and many factors affect it. Treatment generally helps improve prognosis. With treatment, some mesothelioma patients are able to outlive their initial life expectancy by months, years or even decades.

For example, Heather Von St. James is a pleural mesothelioma survivor of more than 19 years. During her diagnosis, doctors said she had 15 months to live. Heather had a multimodal treatment plan that included surgery and heated chemotherapy. Today, she supports mesothelioma patients and advocates for awareness of this disease.

08. Treatment

Mesothelioma Treatment Options

Treatment is the best way to help improve a mesothelioma prognosis. This can include boosting quality of life and extending life expectancy. Traditional treatments for mesothelioma include chemotherapy and surgery. Immunotherapy is a newer treatment method that has recently become standard.

These methods will often be combined to create a comprehensive treatment plan. This approach is called multimodal treatment. Multimodal plans have yielded the best known patient survival outcomes.

Chemotherapy for Mesothelioma Icon

Chemotherapy

Chemotherapy drugs kill cancer cells and stop them from multiplying. For mesothelioma, the standard first-line chemotherapy treatment is cisplatin or carboplatin with Alimta® (pemetrexed). It is often combined with other methods.

Mesothelioma Immunotherapy treatment

Immunotherapy

Immunotherapy helps the body identify and fight cancer cells. It has been successful for patients with average or complex cases. The combo of Opdivo® (nivolumab) and Yervoy® (ipilimumab) has approval for pleural cases.

Mesothelioma Radiation Icon

Multimodal Treatment

Multimodal treatment combines two or more cancer treatments. One common multimodal approach combines surgery and chemotherapy to remove and kill cancer cells.

Mesothelioma surgery icon

Surgery

Surgery is the method of manually removing cancerous tissue. It may be used throughout the various stages of cancer. In later stages, surgery may have a more palliative than therapeutic intent.

Patients may receive these treatments to remove tumor mass, kill cancer cells, manage side effects or improve quality of life. Some aspects of multimodal plans can also help manage side effects caused by treatments.

Mesothelioma cancer research continues examining emerging treatment options. Emerging methods include gene therapy, photodynamic therapy and TTFields. Patients may have access to these treatments in clinical trials.

Mesothelioma doctors can explain which clinical trials patients may qualify for. Doctors may also include emerging methods in specialized mesothelioma treatment plans.

Find Specialized Mesothelioma Treatment

For patients with mesothelioma, receiving specialized care is important. Many doctors may not have experience in treating this rare cancer. However, there are many qualified mesothelioma specialists throughout the United States.

These doctors can develop personalized cancer care plans for patients. They stay more up to date than general oncologists on the latest mesothelioma research and treatments. Mesothelioma specialists can help patients better understand and navigate their diagnosis.

Top Mesothelioma Doctors

Mesothelioma specialist is a broad title that may include different types of doctors. These include palliative care specialists, medical oncologists and thoracic surgeons. Some specialists are also mesothelioma experts with prominent careers in this field.

Photo of Raphael Bueno, M.D.

Raphael Bueno, M.D.

Chief of the Division of Thoracic Surgery and Director of the International Mesothelioma...
Boston, MA
Bio

Photo of Raja M. Flores, M.D.

Raja M. Flores, M.D.

Chairman of the Department of Thoracic Surgery
New York, NY
Bio

Photo of James Pingpank, M.D.

James Pingpank, M.D.

Surgical Oncologist
Pittsburgh, PA
Bio

Photo of Anne S. Tsao, M.D.

Anne S. Tsao, M.D.

Director of the Department of Mesothelioma Program
Houston, TX
Bio

Patients may have a mesothelioma doctor near them. Finding the right specialist is an important step in the treatment process.

Top Mesothelioma Treatment Centers

There are cancer centers across the country with the ability to treat mesothelioma. Many mesothelioma doctors work at these mesothelioma cancer centers. Many of these centers have dedicated mesothelioma teams and may run clinical trials.

Brigham and Women’s Hospital

Brigham and Women’s Hospital

Boston, MA 02115

The University of Chicago Medicine Comprehensive Cancer Center

The University of Chicago Medicine Comprehensive Cancer Center

Chicago, IL 60637

Lung Institute at Baylor College of Medicine

Lung Institute at Baylor College of Medicine

Houston, TX 77030

University of California Los Angeles (UCLA) Medical Center

University of California Los Angeles (UCLA) Medical Center

Los Angeles, CA 90095

Find doctors and cancer centers specializing in mesothelioma treatment near you by selecting your state below.

Find Treatment Options Near You

Find Treatment Options Near You


09. Support

Mesothelioma Support and Resources

Patients, survivors and their loved ones can find support through the mesothelioma community. For example, support groups can connect people with others who understand this disease. There are many other ways to get involved in the community or to show support.

Below are ways to connect with others about a mesothelioma diagnosis, treatment and survivorship.

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Connect with other patients, survivors and their loved ones at mesothelioma events.

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See how you can help raise awareness and support mesothelioma organizations.

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10. Common Questions

Common Questions About Mesothelioma

  • What do patients with mesothelioma experience?
    Common mesothelioma symptoms include cough, fluid buildup, shortness of breath and abdominal or chest pain. Patients may exhibit any number of all possible mesothelioma symptoms. Symptoms can also vary based on the type of mesothelioma.
  • Is mesothelioma a form of cancer?
    Malignant mesothelioma is a rare and aggressive cancer. Pleural mesothelioma develops in the lining around the lungs but is not a form of lung cancer. Mesothelioma can also develop in the lining of the abdomen, in which case it is called peritoneal mesothelioma.
  • Is mesothelioma an aggressive cancer?
    Some experts consider mesothelioma an aggressive cancer, but some forms are less aggressive than others. Despite this fact, expanded treatment options have substantially improved mesothelioma prognosis in recent years.
  • Which key mesothelioma facts should you know?
    • Mesothelioma is a rare cancer with only around 3,000 cases in this country each year.
    • It develops in the linings around the lungs, abdomen, heart and testicles.
    • The most common type occurs in the lining around the lung (pleural mesothelioma).
    • The average life expectancy is 18 – 31 months with treatment.